Which Benzodiazepine is best for alcohol withdrawal? Chlordiazepoxide vs. Diazepam.

Report By: Fiona Reid - Medical Student

Search checked by Fiona Reid - Medical Student

Institution: University of Manchester

Date Submitted: 7th July 2011

Last Modified: 11th July 2011

Status: Blue (submitted but not checked)

Three Part Question

In [patients though to be witdrawing from alcohol] is [Diazepam better than Chlordiazepoxide] at [treating alcohol withdrawal symptoms]?

Clinical Scenario

Patient is in alcohol withdrawal. You want to know which is the best benzodiazepine to prescribe.

Search Strategy

Ovid interface.
Medline 1948 to week 2 June 2011
{[exp.ethanol OR alcohol$.mp] AND [substance withdrawal syndrome.mp OR exp.substance withdrawal syndrome] OR [ex.alcohol withdrawal seizures OR aclohol withdrawal delerium OR alcoholic neuropathy] AND [exp.chlordiazepoxide OR librium.mp] AND [exp.diazepam]}LIMIT to english language AND human.
Embase 1980 to 2011 week 23.
{[exp.alcohol withdrawal OR exp.delirium tremens] AND [chlordiazepoxide OR librium] AND [diazepam]}LIMIT to english language AND human.
CINAHL 1994 to 2011
[alcohol withdrawal] AND [chlordiazepoxide OR librium] AND [diazepam]

Search Outcome

Medline found 26 articles, Embase found 155 articles and CINAHL found 16 articles. A Cochrane review was found to have reviewed all relevant papers up to 2010 and there have been no new studies completed since then.

Relevant Paper(s)

Author, date and country

Patient group

Study type (level of evidence)

Outcomes

Key results

Study Weaknesses

Amato, L. et.al.2010Italy

Cochrane review- 64 studies with a totally of 4309 patients were reviewed. In the comparison between Diazepam and Chlordiazepoxide, 3 studies were found containing a total of 61 patients.